Manager - Provider Relations (Provider Experience)

Requisition ID: 850878
Position:Full-Time
Total Rewards: Benefits/Incentive Information

There's more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth!

Through our commitment to innovation, we're reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what's best, not more of the same. And if what's best hasn't been done yet, it's our exceptional and passionate employees driving this change.

But, our passion for vision isn't just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world's vision crisis.

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear.

In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.

If you're passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America's fastest growing vision benefits company.
GENERAL FUNCTION
The Manager, Provider Experience is responsible for developing, managing, and sustaining relationships with a segment and/or region of network of doctors and their staff to drive high levels of network participation satisfaction. This position requires close collaboration with EyeMed cross-functional teams to fulfill provider requests, answer questions, resolve issues and drive overall day-to-day positive experiences. Key areas of focus include executing strategies to maximize provider participation & retention, increase provider satisfaction and ensure compliance with business and regulatory requirements.
MAJOR DUTIES AND RESPONSIBILITIES

Serve as the account manager & provider relations main point of contact for a segment of independent provider practices participating on the network; manage relationships and is accountable for critical interface with provider offices
Ensure accurate implementation and day-to-day administration of provider groups, partnering with internal teams such as call center, operations, configuration, sales/account management, recruiting and finance
Support new network builds and large recruiting projects
Lead effective provider onboarding and training to use our systems and claim submissions and to service our members with understanding of plan benefits and code procedures
Conduct ongoing outreach to ensure provider satisfaction and identify issues before escalation
Work with network providers to address administrative requests, questions and/or issues, such as contracting, claim and billing, payments and credentialing
Assist in resolving elevated and complex provider service complaints
Conduct service follow-up when work is complete.
Develop and maintain key processes established by the business.
Intake contract negotiation requests and maintain on-going communication with practice during course of review
Fully understand and ensure operationalization of and compliance with legislative changes as they apply to network management including contracts and processes
Attend provider conference and/or events annually in coordination with EyeMed events strategy and provider groups collaboration
Provide complete and timely communication and reporting to manager related to projects in process.

BASIC QUALIFICATIONS

Bachelor's Degree or equivalent work experience
5+ years business experience in relationship management
Ability to work independently and set agenda for area of responsibility including prioritization of work, scheduling, tasks and projects
Ability to work under pressure and think critically in regards to operations and administrative processes
Ability to effectively manage the details of numerous providers simultaneously, set expectations with providers and follows-through on execution
Excellent verbal and written communication skills and customer service skills
Working knowledge of Microsoft suite

PREFERRED QUALIFICATIONS

Experience in network development/management, provider relations, provider operations, call center or sales/account management in health care field
Knowledge and understanding of plan benefit designs, standards of administration, managed vision care and network options for medicaid, medical and surgical plans
Working knowledge of private doctor community
Ability to engage with practices in regards to service reimbursement and negotiations
Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts.

Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com.

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law.

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Nearest Major Market: Cincinnati

Job Segment:
Medicaid, Manager, Healthcare, Management